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19 fresh jobs found
Claims Research & Resolution Lead
Remote US, United States Humana logo Humana
Long Term Services and Supports Trending Claims research Provider education Functional strategies Managed Care Contracts Claims resolution Driver safety program Microsoft Office Applications +66
Senior Mid Full Time
USD 94K+
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Quality Improvement Specialist
Remote-IL, United States Centene Corporation logo Centene Corporation
Intervention Development Performance data analysis RN licensure URAC Member education Internal Auditing Focus Groups Member Outreach Provider education +40
Mid Full Time
USD 55K+
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National Dental Leasing Network and Provider Account Management Professional
Remote US, United States Humana logo Humana
Multi-Priority Management Provider education Provider Contracting Microsoft Office Applications Analyzing Provider Relations Trend Analysis Collaborative BI +34
Mid Full Time
USD 65K+
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Payment Integrity Clinician - (Remote)
PA, Working at Home - Pennsylvania, United States Highmark Health logo Highmark Health
Coding criteria Medical Policies Medical Documentation Payment Integrity Health care services Claims analysis Provider education Utilization management Quality improvement +11
Senior Mid Full Time
USD 57K+
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Physician Coding Auditor
Work at Home - Ohio - Other, United States Ensemble Health Partners logo Ensemble Health Partners
Educational Resource Development Physician coding Coding and Billing Performance review Technical resource Provider education Color Medical Coding Guidance +19
Mid Full Time
USD 51K+
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Provider Engagement Network Specialist
Jackson - 111 E Capitol St., Ste 500 (Magnolia) (10106), United States Centene Corporation logo Centene Corporation
Provider directories Network reporting Demographic information changes Provider information system Contract research Provider data management Medical claims Provider education Claims payment +25
Mid Full Time
USD 44K+
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Clinical Investigator I (Special Investigation Unit)
Remote-FL, United States Centene Corporation logo Centene Corporation
Claims data analysis Provider Billing Billing practices Policy compliance Provider education Guidelines Information Management Medical Coding Clinical Experience +19
Mid Full Time
USD 55K+
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Quality Practice Advisor
Remote-OK, United States Centene Corporation logo Centene Corporation
Risk Adjustment Coding Cphq Documentation standards Medical record documentation Provider education ICD-9 NCQA HEDIS Risk Adjustment +23
Mid Full Time
USD 52K+
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Provider Engagement Account Manager
Remote-OK, United States Centene Corporation logo Centene Corporation
Cost and utilization Network performance Quality measures Utilization Provider education Provider engagement HEDIS Provider Relations Health Plan +28
Mid Full Time
USD 55K+
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Provider Partner Consultant, DentaQuest (Maryland)
DQ Milwaukee WI, United States Sun Life logo Sun Life
Cost performance improvement Value-based pay Oral health presentations Network Recruitment Technology Promotion Client Representation Quality performance Report creation Provider education +22
Mid Full Time
USD 63K+
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Provider Engagement Account Manager (BH Exp)
Remote-MS, United States Centene Corporation logo Centene Corporation
Cost and utilization Network performance Quality measures Provider education Provider engagement HEDIS Health Plan Provider Relations Issue Resolution +26
Mid Full Time
USD 55K+
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Payment Integrity Clinician - RN (Remote)
PA, Working at Home - Pennsylvania, United States Highmark Health logo Highmark Health
Coding criteria Health care services Medical Documentation Payment Integrity Claims analysis Provider education Utilization management RN Managed Care +10
Senior Mid Full Time
USD 57K+
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Pediatric Specialized Coder
Work at Home - Louisiana - Other, United States Ensemble Health Partners logo Ensemble Health Partners
Cardiology coding Cardiothoracic coding Pediatric surgical coding Educational tools Vascular coding Physician coding Coding software Provider education ICD-10-CM +29
Mid Full Time
USD 52K+
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Quality Practice Advisor
Remote-IL, United States Centene Corporation logo Centene Corporation
Clinical Relationship Management Cphq Documentation standards Risk Adjustment Coding Medical record documentation NCQA Provider education Health Plan HEDIS +23
Mid Full Time
USD 52K+
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Coding Compliance Audit & Education Specialist
Remote, USA, United States Privia Health logo Privia Health
MDAudit Technology-driven HIPAA Rules Cloud-based technology HIPAA rules and regulations Coding compliance Athena Provider education ICD-10-CM +16
Mid Full Time
USD 70K+
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Director, National Value-Based Provider Performance and Strategy
Remote US, United States Humana logo Humana
KPI interpretation Provider performance KPI Provider education Provider engagement Strategic direction Value-based care Performance Improvement BI +38
Exec Senior Full Time
USD 150K+
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HCC Physician Coding Auditor
Work at Home - Ohio - Other, United States Ensemble Health Partners logo Ensemble Health Partners
Education Development Physician coding Coding and Billing Technical resource Provider education Risk Adjustment Color Guidance Revenue Cycle Management +17
Mid Full Time
USD 51K+
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Risk Adjustment Auditor II
Portland, OR, United States Cambia Health Solutions logo Cambia Health Solutions
Chart reviews Health systems operations Coding conventions Provider coding Clinical coding ICD-10 Coding DO Reimbursement methodologies Provider education +17
Mid Full Time
USD 62K+
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Provider Educator - Risk Adjustment
Portland, OR, United States Cambia Health Solutions logo Cambia Health Solutions
HCC coding Health Care Industry Knowledge Dental Terminology ICD-10 Coding Reimbursement methodologies Provider education Risk Adjustment Provider Relations Medical terminology +9
Mid Full Time
USD 78K+
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